{"title":"Use of T1 mapping in cardiovascular MRI in follow up of a pediatric fabry cohort","authors":"O. Werner, M. Fila, L. Ichay, M. Vincenti","doi":"10.1016/j.acvdsp.2023.07.034","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Fabry disease<span> (FD) is a rare X-linked lysosomal storage disorder caused by a mutation on the </span></span><em>alpha-galactosidase-A</em><span><span> gene. The prognosis lies in the severity of the cardiac involvement which is the leading cause of mortality. Usually, it presents with hypertrophic cardiomyopathy, valvular disease, or conduction abnormalities. This process of storage is also present in every other organ and begins before </span>birth<span>. Enzyme replacement therapy<span><span> (ERT) has shown a spectacular effect on extra-cardiac symptoms especially if started early in life. The effect of ERT on cardiac lesions is still a research question. Cardiac magnetic resonance (CMR) is a key exam in FD with its capacity of tissular characterization. But to date, there is a lack of data in the </span>pediatric population to understand how to integrate CMR in early therapeutic decisions.</span></span></span></p></div><div><h3>Methods</h3><p>Monocentric cross-sectional study carried out in Montpellier University hospital from 2016 to 2022. All pediatric patients with FD were evaluated over time with clinical, biological and cardiac imaging (CMR, TEE). The objective was to determine the place of CMR in the therapeutic decisions.</p></div><div><h3>Results/Expected results</h3><p>In total, 6 patients were included, 3 boys/3 girls. Five patients were treated with ERT during the study. Low T1 values were observed in 4 patients. The normalization of T1 values was observed in the 4 years after ERT introduction for 3 patients (<span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>CMR has to take an important role in the evaluation of FD. In the pediatric population, a recurrent assessment can be useful to detect the pejorative evolution of T1, especially in partial forms of Fabry disease. Obvious need of strong data is required to help the clinician in his daily practice.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases Supplements","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878648023002550","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by a mutation on the alpha-galactosidase-A gene. The prognosis lies in the severity of the cardiac involvement which is the leading cause of mortality. Usually, it presents with hypertrophic cardiomyopathy, valvular disease, or conduction abnormalities. This process of storage is also present in every other organ and begins before birth. Enzyme replacement therapy (ERT) has shown a spectacular effect on extra-cardiac symptoms especially if started early in life. The effect of ERT on cardiac lesions is still a research question. Cardiac magnetic resonance (CMR) is a key exam in FD with its capacity of tissular characterization. But to date, there is a lack of data in the pediatric population to understand how to integrate CMR in early therapeutic decisions.
Methods
Monocentric cross-sectional study carried out in Montpellier University hospital from 2016 to 2022. All pediatric patients with FD were evaluated over time with clinical, biological and cardiac imaging (CMR, TEE). The objective was to determine the place of CMR in the therapeutic decisions.
Results/Expected results
In total, 6 patients were included, 3 boys/3 girls. Five patients were treated with ERT during the study. Low T1 values were observed in 4 patients. The normalization of T1 values was observed in the 4 years after ERT introduction for 3 patients (Figure 1).
Conclusion/Perspectives
CMR has to take an important role in the evaluation of FD. In the pediatric population, a recurrent assessment can be useful to detect the pejorative evolution of T1, especially in partial forms of Fabry disease. Obvious need of strong data is required to help the clinician in his daily practice.
期刊介绍:
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.